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Comparison of Therapist-Directed and Physician-Directed Respiratory Care in COPD Subjects With Acute Pneumonia.

BACKGROUND: The purpose of this retrospective medical record review was to compare the effects of therapist-directed (protocol RT) and physician-directed (non-protocol RT) respiratory therapy on hospital stay and 30-d post-discharge readmission in COPD subjects with acute bacterial pneumonia. METHOD...

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Published in:Respiratory Care Vol. 60; no. 2; pp. 151 - 155
Main Authors: Werre, Nicholas D., Boucher, Erin L., Beachey, Will D.
Format: research tables/charts Journal Article
Published: Mary Ann Liebert, Inc. Feb2015
Online Access:View this record in EBSCOhost
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      dt: Feb2015
      vid: 60
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      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
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        atl: Comparison of Therapist-Directed and Physician-Directed Respiratory Care in COPD Subjects With Acute Pneumonia.
      aug:
        au:
          Werre, Nicholas D.
          Boucher, Erin L.
          Beachey, Will D.
        affil: Respiratory Care Department, Jamestown Regional Medical Center, Jamestown, North Dakota.
      sug:
        subj:
          Pneumonia, Bacterial Therapy
          Pulmonary Disease, Chronic Obstructive Complications
          Respiratory Therapy Methods
          Respiratory Therapists
          Physicians
          Pulmonary Disease, Chronic Obstructive Therapy
          Treatment Outcomes
          Human
          Retrospective Design
          Record Review
          Descriptive Statistics
          Confidence Intervals
          Chi Square Test
          Analysis of Variance
          Post Hoc Analysis
          Length of Stay
          Readmission
          Severity of Illness
          North Dakota
          Aged
          Education, Continuing (Credit)
          Aged: 65+ years
      ab: BACKGROUND: The purpose of this retrospective medical record review was to compare the effects of therapist-directed (protocol RT) and physician-directed (non-protocol RT) respiratory therapy on hospital stay and 30-d post-discharge readmission in COPD subjects with acute bacterial pneumonia. METHODS: We reviewed 320 medical records; 244 records were usable. Information gathered included gender, age, RT protocol type (protocol RT or non-protocol RT), hospital stay, 30-d post-discharge readmission, and disease severity score. A 3-way analysis of variance and post hoc analysis were performed to determine the possible effects of disease severity, age, and RT protocol type on hospital stay and the possible interaction effects among these independent variables. A chi-square test for independence was computed to determine whether there was an association between RT protocol type and 30-d readmission. RESULTS: There were no significant interaction effects among RT protocol type, age, and disease severity on hospital stay. In addition, there were no significant effects of either RT protocol type (P = .41) or age (P = .85) on hospital stay in our subject sample. However, as expected, disease severity had a significant effect on hospital stay, increasing it by a mean of 2.6 d (95% CI 0.77– 4.4, P = .005). The chi-square test for independence revealed that the frequency of 30-d readmission was significantly associated with RT protocol type (P = .02); fewer 30-d readmissions were associated with protocol RT. CONCLUSIONS: We interpreted the finding of no difference in mean hospital stay between protocol and nonprotocol RT to indicate that protocol RT did not confer a disadvantage to subjects in terms of hospital stay. Additionally, the results suggest that treatment efficacy is not sacrificed when RT is directed by respiratory therapists rather than by physicians regardless of disease severity and that therapist-directed protocols may have been of some benefit in reducing 30-d post-discharge readmission.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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